Diabetic kids may focus too much on carb counting

NEW YORK (Reuters Health) - Keeping tabs on carbohydrates can help young people with type 1 diabetes control their blood sugar. But they should also be careful about putting too much emphasis on carb counting alone, researchers say.

Nutrition counseling for children and teens with type 1 diabetes often recommends carb counting. By calculating the grams of carbohydrates in a meal or snack, diabetics can more closely control blood sugar levels and adjust their doses of insulin appropriately.

People with type 1 diabetes do not produce insulin, a blood sugar-regulating hormone, and must take multiple doses of synthetic insulin each day.

But in the new study, published in the journal Diabetes Care, researchers found that parents and kids sometimes put too much emphasis on carb quantity at the expense of diet quality.

In interviews with 35 8- to 21-year-olds and their parents, the researchers found that some preferred packaged processed foods to "whole" foods, like fruits, whole grains and legumes, because the carb content was readily available on the product labels.

In addition, some parents limited their children's intake of healthy choices like fruit and whole grains because of their carbohydrate content.

This was despite the fact that parents and kids alike usually believed that fruits and vegetables were generally healthy foods, while "junk food" and fast food should be limited.

Carb counting remains an "important tool" for adjusting insulin doses, Drs. Lori M.B. Laffel and Sanjeev N. Mehta, two of the researchers on the study, told Reuters Health in an email.

"However, healthful nutrition involves more than just carbohydrates," said the researchers, who are based at the Joslin Diabetes Center and Harvard Medical School in Boston.

A "healthy" diet, they added, is one that is moderate in calories and includes enough protein, "good" unsaturated fats, healthful carbohydrates and vitamins and minerals, among other nutrients.

Laffel and Mehta said it is important for families of children with diabetes to meet with a nutritionist at the time of diagnosis and then about once a year, to get specific advice on healthy eating.

When it comes to carb counting, they said, there are ways to easily calculate what's in fresh produce and other whole foods. A nutritionist will help with this, and there are also many reference sources, including books and Web sites, available for estimating foods' carb content.

Getting a kitchen scale to weigh fruits and other whole foods is also a good idea, the researchers noted.